title: The multidimensionality of spiritual wellbeing: peace, meaning, and faith and their association with quality of life and coping in oncology.
abstract: OBJECTIVE
  This study explored associations between the recently proposed three-factor structure of the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp) subscale (Peace, Meaning, and Faith), quality of life (QoL), and coping in an oncology population.
  
  
  METHODS
  A total of 999 newly diagnosed, study eligible, consecutive cancer patients completed the FACIT-Sp and the Mental Adjustment to Cancer (MAC) scale.
  
  
  RESULTS
  Hierarchical multiple regressions revealed that Peace alone added 3% to the prediction of QoL and accounted for 15.8% of the overlap in Total Functional Assessment of Cancer Therapy--General (FACT-G) scores (both p<0.001). Meaning alone added 1.3% to QoL prediction and accounted for 5.8% in overlap (both p<0.001). Faith did not significantly contribute to the unique prediction or overlap of QoL. Correlational analyses revealed that Peace was most prominently associated with the QoL subscales of Functional (r = 0.64) and Emotional Wellbeing (r = 0.61) and the coping styles of Helpless/Hopeless (r = -0.53), Fighting Spirit (r = 0.47), and Anxious Preoccupation (r = -0.34). Meaning was also highly associated with Functional Wellbeing (r = 0.56), Helpless/Hopeless (r = -0.53), and Fighting Spirit (r = 0.54), but in addition, Social Wellbeing (r = 0.49).
  
  
  CONCLUSIONS
  The three-factor model of spiritual wellbeing appears psychometrically superior to previous models as it further discriminates between which components are most highly associated with improved QoL facets and coping styles. This study provides normative data on newly diagnosed patients with cancer and further highlights the clinical contribution of such detailed assessment.
authors.affiliation: Cancer Council Australia, Sydney, NSW, Australia. hayley.whitford@cancer.org.au
authors.forename: Hayley S
authors.initials: HS
authors.lastname: Whitford
authors.forename: Ian N
authors.initials: IN
authors.lastname: Olver
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010549:Personal Satisfaction; D010555:Personality Inventory; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life; D012959:Socioeconomic Factors; D029181:Spirituality; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D026712:Value of Life